(Please print this form, fillout and mail with a $75.00 deposit)

RegistrationForm

DigitalDouble 3D Animation Immersion Program

MailTo:

15814Bear Creek Parkway

Redmond,WA 98052


Aweeklong hands-on animation experience for middle to high school students (ages9-19)

 

Whichsession/s are you registering for? (Please check one)

 

Morning

(9am-1pm)

Afternoon

(2pm-6pm)

Dates

 

 

July 5-9 th (tue-sat)

 

 

July 11-15th

 

 

July 18-22nd

 

 

July 25-29th

 

 

Aug 1-5th

(advanced)

 

Inthe event that your choice is full, please list alternative sessions in orderof preference:

 

1st:

2nd:

3rd:

Studentinformation

 

Name

 

Age

 

School and grade in fall

 

Address

 

Phone number(s)

 

Email

 

How did you hear about this program?

 

 

 

Parent/guardianinformation

 

Name(s)

 

Address (if different from student)

 

Phone number(s)

 

Email

 

 

Medicalinformation

 

Emergency contacts (names and phone #s)

 

Doctor (phone # and address)

 

Medical insurance provider

 

Policy number

 

Dentist name

 

Dental insurance provider

 

Policy number

 

 

 

DietaryRestrictions/Preferences (circle one each)

 

Vegetarian

Yes

No

 

Vegan

Yes

No

 

Lactose intolerant

Yes

No

 

Allergies

Yes

No

If yes, please explain:

Other

Yes

No

If yes, please explain:

 

Do you have any handicaps, limiting health conditions, medications, reactions tomedications or any additional medical/health information that we should knowabout?

 

 

 

Finally, could you tell us abit about how you found out about us?

 

 

 

 

 

Program information:Program cost ($540 total) includes 20 hours of instruction (including breaks) fromprofessionals in the field and experienced educators; snacks and beverages; useof required hardware and software; notebook, sketchbook and writing/drawingutensils will all be provided.

 

Pleasenote: this is a closed campusprogram.  Students will not be allowed toleave the premises during program hours except with a parent or guardianwithout prior written parental consent. All instruction will occur at Digital Double’s studio, located at 15814Bear Creek Parkway (2nd floor) Redmond, WA 98052. Program is not aninternship or employment, nor is it training for future employment.  Program is not accredited or affiliated withany educational institution.

 

Refundpolicy: The $75 deposit is non-refundable.  Thebalance of $465 is due at 9am on the first day of your session, and isrefundable only in extenuatingcircumstances (ie. serious illness or familyemergency).  In the event of classcancellation due to low enrollment, you will be offered the choice of attendinganother session, or a full refund (including deposit). 

Studentwill be expected to make their own transportation arrangements for arriving andleaving on time.

 

I,__________________ (parent or guardian name) hereby agree to not hold DigitalDouble and its agents liable for any injuries or incidents that may occurduring the course of this program.  Bysigning, I also give Digital Double and its agent’s permission to call formedical transport in case of a medical emergency. 

 

 

 

_____________________

Parentsignature

 

 

 

_____________________

Studentsignature

 

 

 

Questions?  Call (425) 867-0400 or emailinfo@digitaldouble.net

 

Pleasesend completed form and $75 deposit to:

DigitalDouble

15814Bear Creek Parkway

Redmond,WA 98052